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Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection (ICSI) has dramatically increased pregnancy rates in couples suffering from severe male infertility (low sperm counts) and in some cases of infertility of unknown cause(s). ICSI is a laboratory procedure that helps infertile couples undergoing the standard in vitro fertilization (IVF) procedure, with the exception that after the eggs are retrieved, the sperm is injected directly into the egg.
With the advent of ICSI, the majority of causes for severe male factor infertility can be successfully treated. ICSI is especially effective for the following causes of infertility:
- low numbers of motile sperm
- problems with sperm penetrating the egg or binding to the egg
- severe teratospermia
- the presence of antisperm antibodies which are thought to be the cause of infertility
- prior or repeated fertilization failure using standard in vitro fertilization (IVF) methods
- a low number and quality of frozen sperm
- obstruction of the male reproductive tract that is unable to be repaired
- unexplained infertility
ICSI has been shown to increase the likelihood of fertilization when abnormalities in the number, quality or function of the sperm exist. However, ICSI is generally unsuccessful when used to treat fertilization failures that are primarily the result of poor egg quality.
ISCI has not be shown to increase the incidence of multiples, as compared to the standard IVF procedure. However, as a relatively new technique first performed in 1992, there is little long-term data regarding the future health and fertility of children conceived via ICSI.
In cases where the male reproductive tract is obstructed and unable to be repaired, sperm may still be obtained via microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE). MESA and TESE allow men with little or no sperm in their ejaculate to produce a pregnancy. During MESA and TESE, sperm is extracted directly from the male's reproductive tract, is specially prepared, and then a single sperm is inserted into the female's egg.
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